Global vaccine issues

Question 1

what are the social determinants of health

Answer 1

the conditions in which people are born, grow, live, work and age
- mostly responsible for health inequalities

Question 2

what measures are used to compare how effective different countries are at improving child health

Answer 2

1. mortality
   - neonatal mortality rate: number of deaths of babies under 28 days old, per 1000 live births in a given time period
   - infant mortality rate: number of deaths in children under 1, per 1000 live births in a given time period
   - under 5 mortality rate: number of deaths of children under 5, per 1000 live births in a given time period

Question 3

what is the leading cause of under 5 deaths in sub saharan Africa and South Asia

Answer 3

diarrhoea and pneumonia
- potentially preventable by vaccination

Question 4

what are the characteristics of rotavirus

Answer 4

1. at least 28 strains
2. common in infants and under 5s
3. severe watery diarrhoea, vomiting, fever and abdominal pain
4. lasts 3-8 days
5. highly infectious- faecal- oral transmission

Question 5

outline the vaccinations available against rotavirus

Answer 5

live attenuated strain of human rotavirus
1. Rotarix- 2 doses 4 weeks apart, before 24 weeks of age
2. Rotateq- 3 doses 4 weeks apart before 26 weeks of age

Question 6

what are the characteristics of streptococcus pneumoniae

Answer 6

1. gram +, encapsulated diplococcus
2. droplet transmission
3. causes pneumococcal pneumonia, meningitis, sepsis, otitis media and sinusitis
4. exacerbated by crowding, indoor air pollution, tobacco smoke, immunosuppression, lack of exclusive breastfeeding
5. resistance to penicillins and other antibiotics is common

Question 7

what are the characteristics of haemophilus influenzae

Answer 7

1. small gram - bacterium
2. several serotypes based on capsular polysaccharides
3. type b (Hib) most virulent
4. transmission by respiratory droplets
5. causes pneumonia, bacteraemia, cellulitis, meningitis, septic arthritis in under 5s

Question 8

describe the effectiveness of the rotavirus vaccine

Answer 8

reduced very severe rotavirus infection by 74%

Question 9

describe the effectiveness of the Hib vaccine

Answer 9

reduces pneumonia by 18%

Question 10

describe the effectiveness of the pneumococcal conjugate vaccine (PCV)

Answer 10

23-35% reduction in pneumonia and drop in pneumonia mortality

Question 11

what are the barriers to vaccination

Answer 11

1. conflict
2. politics
3. violence against health workers
4. beliefs about vaccines
5. weak or disrupted health care systems
6. affordability
7. covid 19 pandemic

Question 12

give examples of solutions to barriers to vaccinations

Answer 12

1. health system strengthening
   - funding
   - supply chain
2. education
3. improved monitoring
4. affordability